Acceptability and Feasibility of Self-Collected Dried Blood Spot Specimens for Viral Load Monitoring among Rural Older People Living with HIV.

Self-collected dried blood spot (DBS) samples may be useful in monitoring viral load (VL) in research studies or clinically given that they eliminate the need for participants to travel to study sites or laboratories. Despite this, little information exists about monitoring VL using DBS self-collected at home, and no information exists on DBS for this use among older rural people living with HIV (PLH), a population that could benefit from self-collection given difficulty accessing care. We report on the feasibility and acceptability of self-collected DBS samples, DBS VL results, concordance between self-reported and DBS VL, and factors associated with DBS detectable VL in a rural Southern U.

Ways to Measure Metals: From ICP-MS to XRF.

Purpose Of Review: This review explores the use of Inductively Coupled Plasma Mass Spectrometry (ICP-MS) and X-ray Fluorescence (XRF) for quantifying metals and metalloids in biological matrices such as hair, nails, blood, bone, and tissue. It provides a comprehensive overview of these methodologies, detailing their technological limitations, application scopes, and practical considerations for selection in both laboratory and field settings. By examining traditional and novel aspects of each method, this review aims to guide researchers and clinical practitioners in choosing the most suitable analytical tool based on their specific needs for sensitivity, precision, speed, and sample preparation.

Improved display and detection of small renal stones using photon-counting detector CT compared to conventional energy-integrating detector CT.

Purpose: To compare same-day photon-counting detector CT (PCD-CT) to conventional energy-integrating detector CT (EID-CT) for detection of small renal stones (≤ 3 mm).

Methods: Patients undergoing clinical dual-energy EID-CT for known or suspected stone disease underwent same-day research PCD-CT. Patients with greater than 10 stones and no visible stones under 3 mm were excluded.

T1 signal intensity ratio variability based on sampling strategies in the pancreas of children and young adults.

Purpose: T1-weighted signal intensity ratios (SIR) comparing pancreas to spleen (SIRps) or muscle (SIRpm) can semiquantitatively assess T1 signal change associated with pancreatitis. However, there is no standardized methodology for generating these ratios. We set out to determine the impact of MRI sequence as well as region of interest (ROI) location, shape, and size on T1 SIR.

Changes in the treatment and outcomes of different severities of neonatal hypoxic ischemic encephalopathy in California: a retrospective cohort study.

Objective: Evaluate the changes in management and outcomes of Californian infants with hypoxic ischemic encephalopathy (HIE).

Study Design: Infants with HIE were identified from a California administrative birth cohort using ICD codes and divided into two epochs, Epoch 1 (2010-2015) and Epoch 2 (2016-2019). Risk ratios (RR) for induced hypothermia (IH) in each epoch and their outcomes were calculated using log-linear regression.

Global transcriptional modulation and nutritional status of soybean plants following foliar application of zinc borate as a suspension concentrate fertilizer.

The management of micronutrients, such as boron (B) and zinc (Zn), is critical for plant growth and crop yields. One method of rapid intervention crop management to mitigate nutritional deficiency is the foliar supply of B and Zn. Our study investigates the effect of foliar-supplied B and Zn availability on the global transcriptional modulation in soybean (Glycine max).

Cardiovascular disease attenuates the protective effect of folate on global cognitive function in an elderly population: a cross-sectional study.

Research suggests that folic acid contributes to improving cognitive function. However, there is a lack of systematic research on the association of dietary intake of folate and serum, and red blood cell (RBC) folate levels with global cognitive impairment (CoI) in the elderly population. Importantly, excessive supplementation with folate among American adults at high risk of cardiovascular disease (CVD) may have harmful effects.

Subendocardial ischemia: does CMD really exist?

Patients with angina but without obstructive epicardial coronary disease still require a specific mechanistic diagnosis to enable targeted treatment. The overarching term "coronary microvascular dysfunction" (CMD) has been applied broadly - but is it correct? We present a series of case examples culminating a systematic exploration of our large clinical database to distinguish among four categories of coronary pathophysiology. First, by far the largest group of "no stenosis angina" patients exhibits subendocardial ischemia during intact flow through diffuse epicardial disease during dipyridamole vasodilator stress.

Radiotherapeutics, clonal hematopoiesis, and risk of hematologic malignancies: The good, the bad, the ugly.

While radiotherapeutics have demonstrated significant clinical benefit across multiple cancer types including thyroid cancer, neuroendocrine tumors, and prostate cancer, hematological toxicities can be frequent and challenging. It remains unknown to what extent the hematologic toxicity is driven by clonal processes that preexist and are selected for by treatment induced selection pressures. In this review, we discuss the background leading to the adoption of radiotherapeutics in the treatment of solid tumor malignancies, the risk of hematologic toxicities and myeloid neoplasms and the evidence pointing to potential precursor lesions that may predispose patients to hematologic toxicities.

Identifying Preferred Features of Influenza Vaccination Programs Among Chinese Clinicians Practicing Traditional Chinese Medicine and Western Medicine: Discrete Choice Experiment.

Background: Achieving high vaccine coverage among clinicians is crucial to curb the spread of influenza. Traditional Chinese medicine (TCM), rooted in cultural symbols and concepts without direct parallels in modern Western medicine, may influence perspectives on vaccination. Therefore, understanding the preferences of TCM clinicians towards influenza vaccines is of great importance.

Performance of an Electronic Health Record-Based Automated Pulmonary Embolism Severity Index Score Calculator: Cohort Study in the Emergency Department.

Background: Studies suggest that less than 4% of patients with pulmonary embolisms (PEs) are managed in the outpatient setting. Strong evidence and multiple guidelines support the use of the Pulmonary Embolism Severity Index (PESI) for the identification of acute PE patients appropriate for outpatient management. However, calculating the PESI score can be inconvenient in a busy emergency department (ED).

Interpretable Machine Learning Model for Predicting Postpartum Depression: Retrospective Study.

Background: Postpartum depression (PPD) is a prevalent mental health issue with significant impacts on mothers and families. Exploring reliable predictors is crucial for the early and accurate prediction of PPD, which remains challenging.

Objective: This study aimed to comprehensively collect variables from multiple aspects, develop and validate machine learning models to achieve precise prediction of PPD, and interpret the model to reveal clinical implications.

Classifying Unstructured Text in Electronic Health Records for Mental Health Prediction Models: Large Language Model Evaluation Study.

Background: Prediction models have demonstrated a range of applications across medicine, including using electronic health record (EHR) data to identify hospital readmission and mortality risk. Large language models (LLMs) can transform unstructured EHR text into structured features, which can then be integrated into statistical prediction models, ensuring that the results are both clinically meaningful and interpretable.

Objective: This study aims to compare the classification decisions made by clinical experts with those generated by a state-of-the-art LLM, using terms extracted from a large EHR data set of individuals with mental health disorders seen in emergency departments (EDs).

Faculty Perceptions on the Roles of Mentoring, Advising, and Coaching in an Anesthesiology Residency Program: Mixed Methods Study.

Background: Mentoring, advising, and coaching are essential components of resident education and professional development. Despite their importance, there is limited literature exploring how anesthesiology faculty perceive these practices and their role in supporting residents.

Objective: This study aims to investigate anesthesiology faculty perspectives on the significance, implantation strategies, and challenges associated with mentorship, advising, and coaching in resident education.

Performance of ChatGPT-3.5 and ChatGPT-4 in the Taiwan National Pharmacist Licensing Examination: Comparative Evaluation Study.

Background: OpenAI released versions ChatGPT-3.5 and GPT-4 between 2022 and 2023. GPT-3.

Hypothalamic neural circuits regulating energy expenditure.

The hypothalamus plays a central role in regulating energy expenditure and maintaining energy homeostasis, crucial for an organism's survival. Located in the ventral diencephalon, it is a dynamic and adaptable brain region capable of rapid responses to environmental changes, exhibiting high anatomical and cellular plasticity and integrates a myriad of sensory information, internal physiological cues, and humoral factors to accurately interpret the nutritional state and adjust food intake, thermogenesis, and energy homeostasis. Key hypothalamic nuclei contain distinct neuron populations that respond to hormonal, nutrient, and neural inputs and communicate extensively with peripheral organs like the gastrointestinal tract, liver, pancreas, and adipose tissues to regulate energy production, storage, mobilization, and utilization.

The growing complexity of the control of the hypothalamic pituitary thyroid axis and brown adipose tissue by leptin.

The balance between food intake and energy expenditure is precisely regulated to maintain adipose stores. Leptin, which is produced in and released from adipose in direct proportion to its size, is a major contributor to this control and initiates its homeostatic responses largely via binding to leptin receptors (LepR) in the hypothalamus. Decreases in hypothalamic LepR binding signals starvation, leading to hunger and reduced energy expenditure, whereas increases in hypothalamic LepR binding can suppress food intake and increase energy expenditure.

Irregular sleep-wake rhythm disorder: From the pathophysiologic perspective to the treatment.

Irregular sleep-wake rhythm disorder (ISWRD) is an intrinsic circadian rhythm disorder caused by loss of the brain's circadian regulation, through changes of the input and/or output to the suprachiasmatic nucleus (SCN), or of the SCN itself. Although there are limited prevalence data for this rare disease, ISWRD is associated with neurodegenerative disorders, including the Alzheimer disease (AD) and the Parkinson disease (PD), which will become increasingly prevalent in an aging population. It additionally presents in childhood developmental disorders, psychiatric disorders, and traumatic brain injury (TBI).

Rhythms of light: Understanding the role of circadian timing in alertness and cognitive performance.

The nonimage-forming effects of light are pivotal in regulating cognitive functions, including alertness, sustained attention, and higher-order cognitive processes. These cognitive domains are deeply influenced by the sleep-wake cycle, which are governed by two key processes: the homeostatic process, which builds sleep pressure during wakefulness, and the circadian process, which aligns with environmental light cues to regulate wakefulness and sleep. When these processes fall out of sync-a condition known as circadian misalignment-alertness, sustained attention, and cognitive performance can suffer significantly.

Optimizing autonomous artificial intelligence diagnostics for neuro-ocular health in space missions.

Spaceflight-Associated Neuro-Ocular Syndrome (SANS) presents a critical risk in long-duration missions, with microgravity-induced changes that threaten astronaut vision and mission outcomes. Current SANS monitoring, limited to pre- and post-flight exams, lacks in-flight diagnostics, highlighting an urgent need for autonomous tools capable of real-time assessment. Grok, an AI platform by xAI, offers promising potential as an advanced diagnostic tool for space-based health monitoring.

The Effects of Cosmic Radiation Exposure on Pregnancy During a Probable Manned Mission to Mars.

Space missions have revealed certain disincentive factors of this unique environment, such as microgravity, cosmic radiation, etc., as the aerospace industry has made substantial progress in exploring deep space and its impacts on human body. Galactic cosmic radiation (GCR), a form of ionizing radiation, is one of those environmental factors that has potential health implications and, as a result, may limit the duration - and possibly the occurrence - of deep-space missions.

Galactic cosmic ray environment predictions for the NASA BioSentinel Mission, part 2:Post-mission validation.

The BioSentinel CubeSat was deployed on the Artemis-I mission in November 2022 and has been continuously transmitting physical measurements of the space radiation environment since that time. Just before mission launch, we published computational model predictions of the galactic cosmic ray exposure expected inside BioSentinel for multiple locations and configurations. The predictions utilized models for the ambient galactic cosmic ray environment, radiation physics and transport, and BioSentinel geometry.